COMPARISON OF EFFICACY OF DIFFERENT DRUG COMBINATIONS IN ACUTE SCIATICA
- Conditions
- Sciatica AcuteSciatica
- Interventions
- Registration Number
- NCT05626140
- Lead Sponsor
- Pakistan Institute of Medical Sciences
- Brief Summary
The goal of this clinical trial is to compare different combinations of diclofenac with diclofenac monotherapy in acute sciatica. The main questions it aims to answer are:
* Does the combination of diclofenac plus codeine better than diclofenac monotherapy for treating severe pain of sciatica
* Does the combination of diclofenac plus lacosamide better than diclofenac monotherapy for treating severe pain of sciatica
Participants will be asked to mark their pain intensity on a visual analog scale and fill oswestry disabilit index questionnaire,treatments they'll be given includes either
1. Diclofenac monotherapy
2. Diclofenac plus codeine
3. Diclofenac plus lacosamide
Researchers will compare the above three groups to see if severity of pain and disability lowered after medication
- Detailed Description
Musculoskeletal conditions are the most common cause of intense long-term pain, physical disability and early deaths. They affect hundreds of millions of people of all ages irrespective of social strata globally. Lumbar radicular pain (LRP), commonly referred to as "Sciatica" is a relatively common musculoskeletal disorder.
Objective of the study is to evaluate the efficacy of different drug combinations with diclofenac for the treatment of acute sciatica. The design of the study is Single-center, clinical trial with three arms. (Single Blinding). One hundred and twenty patients were enrolled in this study between September 2021 and July 2022 at the Pharmacology department of Islamic International Medical College (IIMC) Rawalpindi in collaboration with the Neurosurgery Department, of Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU) Pakistan Institute of Medical Sciences (PIMS) Islamabad. Informed verbal and written consent was taken from all patients. 40 patients were in the diclofenac (50 mg) plus placebo group, 40 in the codeine (30 mg) plus diclofenac (50 mg) group and 40 in lacosamide (50 mg) plus diclofenac (50 mg) group. Patients were followed up at day 5, 10 and 15 to assess change in pain intensity and functional disability. The use of rescue analgesia was also assessed at the final day of outcome
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 120
- Patients diagnosed with acute sciatica with or without lower back pain
- 18-70 years of age reporting acute pain due to sciatica
- Pregnant or breastfeeding mothers.
- History of asthma or allergy to anti-inflammatory drugs.
- Mentally handicapped or terminally ill patients.
- Age less than 18 years or above 70 years
- Patients with herniated, sequestrated, or prolapsed discs waiting for surgery.
- Patient having an active ulcer (gastric or duodenal) or bleeding from the stomach or bowel.
- Patients already taking an anti-depressant medication, a medication for neuropathic pain, an anticonvulsant, or a sedative and unable to cease the medication
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Diclofenac plus lacosamide Lacosamide 50 MG Oral Tablet [Vimpat] Oral tablet diclofeanc sodium 50 mg was given with tab lacosamide 50 mg as placebo ,12 hourly for 15 days Diclofenac plus placebo Diclofenac Sodium Oral tablet diclofeanc sodium 50 mg was given with tab folic acid 5 mg as placebo ,12 hourly for 15 days Diclofenac plus codeine Codeine Phosphate Oral tablet diclofeanc sodium 50 mg was given with tab codeinephosphate 30 mg ,12 hourly for 15 days Diclofenac plus lacosamide Diclofenac Sodium Oral tablet diclofeanc sodium 50 mg was given with tab lacosamide 50 mg as placebo ,12 hourly for 15 days Diclofenac plus codeine Diclofenac Sodium Oral tablet diclofeanc sodium 50 mg was given with tab codeinephosphate 30 mg ,12 hourly for 15 days
- Primary Outcome Measures
Name Time Method Pain Intensity Patients were asked to mark a line and record their pain scores at baseline and day 5, day 10 and day 15 Severity of leg pain or lower back pain associated with acute sciatica to be assessed using the visual analog scale VAS to determine if the mean pain scores decreased during the course of the medication. VAS is a commonly used pain score in interventinal studies and evaluating pain intensity related with musculoskeletal disorders or post opertive types of pain. For this , the patient is asked to mark a line anywhere on a 10 cm line with 0 taken on the left edge. The mark drawn on the line corresponds to the intensity pf pain experienced by the patient at the time of the pain assessment
- Secondary Outcome Measures
Name Time Method Functional Disbability ODI was measured at baseline and days 5,10, and 15 and patients were asked to fill the questionnaire on the respective days The ODI is an index derived from the Oswestry Low Back Pain Questionnaire. The self-administered questionnaire consists of ten topics related to intensity of pain, lifting, ability of self-care, potential to walk, capacity to sit, sexual function, strength to stand, social life, quality of sleep, and capability to travel. Each category (topic) is then followed by 6 statements relating different potential scenarios in the patient's life concerning to the topic. Patients are inquired to specify the statement that most strictly is similar to their situation. Statements are linked with scores from 0 to 5, where 0 represents the lowest disability and 5 equivalent to extreme disability. The sum of the ten scores is stated as a percentage of the maximum score (50) ranging from 0% = no disability to 100% = maximum disability
Trial Locations
- Locations (1)
Mehreen Mirza
🇵🇰Rawalpindi, Punjab, Pakistan